New studies show that legal cannabis access reduces opioid abuse

Scientific data is growing nearly by the day in support of the notion that legalized cannabis can mitigate opioid use and abuse.

For instance, among states where medical cannabis access is permitted, patients routinely lessen their opioid intake. According to data published this week by the Minnesota Department of Health, among those patients known to be taking opiate painkillers upon their enrollment into the program, 63 percent “were able to reduce or eliminate opioid usage after six months.”

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Minnesota’s findings are hardly unique. In 2016 there was data gathered from patients enrolled in Michigan’s cannabis access program reported that marijuana treatment “was associated with a 64 percent decrease in opioid use, decreased number and side effects of medications, and an improved quality of life.”

A review of state-registered patients from various northeastern states yielded similar results, finding, 77 percent of respondents acknowledged having reduced their use of opioids following cannabis therapy.

A 2017 assessment of medical cannabis patients in Illinois revealed that participants in the state-run program frequently reported using marijuana "as an alternative to other medications -- most commonly opioids, but also anticonvulsants, anti-inflammatories, and over-the-counter analgesics."

Two just-published clinical trials from Israel — where medical cannabis use is legally permitted — further affirm this phenomenon. In the first study, which assessed cannabis use among the elderly, investigators reported that over 18 percent of the study's participants "stopped using opioid analgesics or reduced their dose" over a six-month period.

They concluded, "Cannabis can decrease the use of other prescription medicines, including opioids." In the second trial, which assessed the safety and efficacy of cannabis in a cohort of over 1,200 cancer patients, scientists reported that nearly half of respondents reported either decreasing or eliminating their use of opioids during the treatment period

Another recently published clinical trialprovides insight into explaining this relationship. Investigators from Columbia University’s Medical Center assessed the efficacy of low doses of inhaled cannabis and sub-therapeutic doses of oxycodone on experimentally-induced pain in a double-blind, placebo-controlled model.

Researchers assessed subjects’ pain tolerance after receiving both substances separately or in concert with one another. While neither the administration of cannabis nor oxycodone alone significantly mitigated subjects’ pain, the combined administration of both drugs did so effectively.

Authors determined, “Both active cannabis and a low dose of oxycodone (2.5 mg) were sub-therapeutic, failing to elicit analgesia on their own; however, when administered together, pain responses … were significantly reduced, pointing to the opioid-sparing effects of cannabis.” They concluded, “Smoked cannabis combined with an ineffective analgesic dose of oxycodone produced analgesia comparable to an effective opioid analgesic dose without significantly increasing cannabis abuse liability.”

Paul Armentano is the deputy director of the National Organization for the Reform of Marijuana Laws (NORML). He is the co-author of the book, Marijuana Is Safer: So Why Are We Driving People to Drink? And the author of the book, The Citizen’s Guide to State-By-State Marijuana Laws.